Addressing the Opioid Crisis

Last year, more than 72,000 Americans died due to drug overdoses, a 1o percent increase from a year earlier – 49,000 of these were related to opioids.

In 2016, HHS estimated that 11.8 million Americans abused opioids, signaling one of the most pressing public health issues in the U.S. and leading President Trump to declare a public health emergency.

The Senate will soon vote on the Opioid Crisis Response Act, which fills funding gaps for research, local services, and detecting the importation of illicit drugs, such as fentanyl.

The Centers for Disease Control and Prevention estimatesthat 72,287 Americans died from a drug overdose last year. Over 49,000 of deaths were associated with opioids, which include substances such as fentanyl and heroin. The annual numbers continue to climb, with the death toll for 2017 nearly 10 percent higher than a year earlier. Experts believe the rise is attributable to opioids being more readily available and more potent than previous versions of the drugs. The Senate will likely soon act on legislation to curb the problems of over prescribing, abuse, and illegal importation of illicit substances.

CDC Annual Estimates: Opioid-Related Overdose Deaths

A crisis in the making

Drug overdoses are now the leading cause of accidental deaths for Americans under age 50. In 2016, the number of overdose deaths involving opioids – including prescription pills and heroin – was five times higherthan in 1999. Many believe the crisis is responsible for a decline in life expectancy in the U.S., dropping in 2016 for the second consecutive year to 78.6 years.

The crisis of opioid addiction and overdose today threatens nearly every community across the U.S., and has been decades in the making. Many scholars look back to the 1990s, when doctors began prescribing opioids more liberally following the American Pain Society’s recommendation that pain be considered the “fifth vital sign,” alongside blood pressure, pulse, respiration rate, and body temperature.

Liberal prescribing made painkillers more readily available and easier to abuse. Opioids became more accessible to the public — non-patients could obtain and abuse them, many accessing prescription pain pills from unknowing family and friends.

Sally Satel, a noted psychiatrist and expert at the American Enterprise Institute, has explained: “In turn, millions of unused pills end up being scavenged from medicine chests, sold or given away by patients themselves, accumulated by dealers and then sold to new users for about $1 per milligram. As more prescribed pills are diverted, opportunities arise for nonpatients to obtain them, abuse them, get addicted to them and die.”

Change in Overdose Deaths 2016-2017

Prescription opioids, while effective at relieving pain, come with considerable risks. The government took measures to reduce opioid prescribing, causing pharmaceutical companies and prescribers to respond. Between 2010 and 2015, opioid prescriptions decreasedby 22 percent on a per person basis. Despite the substantial reduction, the 2015 prescribing rate is still three times higher than it was in 1999.

Even as prescription rates were dropping, deaths related to opioids continued to rise, with lives lost to opioids reaching a record level in 2014. According to the CDC, 2014 saw a 14 percent increase in opioid overdose deaths in one year. Some people turned to heroin and other illicit substances as these drugs were easy to obtain and cheaper than prescription painkillers.

The Department of Health and Human Services estimated that in 2016 as many as 11.8 million people misused opioids, a number that included heroin and prescription pain pills. It also included nearly 1 in 14 people between the ages of 18 and 25.

Opioid-related deaths are typically not caused by one opioid alone but by a lethal combination. The overdose death rate has increased as abusers combine heroin with drugs like fentanyl, a drug as much as 100 times more potent than morphine.

curtailing the damage

In 2017, President Trump declaredthe opioid crisis a national public health emergency and established a presidential commission to combat it. Since then, the administration has released more than $6 billion to aid prevention and treatment efforts at the state and local level.

In addition, the FDAreleased new guidance to bring safe and effective treatments to the market for substance abuse patients. The agency is also focused on reducing access to illicit substances, issuing a warningto illegal online vendors selling opioids.

The Senate is poised to act in the coming weeks. The HELP, Finance, Judiciary, and Commerce committees have advanced bipartisan legislation that may be considered soon. The Opioid Crisis Response Act includes critical funding to help states. It ensures research is expedited and patients have access to substance-abuse treatment. The bill improves detection measures for illegal imports through the U.S. mail, to reduce the supply of illicit drugs.

Republicans have agreed to take up the legislation. Should Democrats agree, a vote could come within the next week.